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Understanding the Affordable Care Act: A Fact Sheet Series by SEARAC

Better Health Care for Elders: How Medicare and Medicaid Recipients Benefit from the ACA Soukai Lukhamchak 65 years old Minneapolis, MN His Story: My name is Soukai Lukhamchak, and I am 65 years old. My wife, Soudchai, is 60 years old. We are both disabled as a result of a car accident. We also have chronic illnesses, including diabetes, that require regular treatment and medication. We pay between $200 and $300 a month for our prescription medications and $500 for rent. Our disability benefits are just $505 per person per month. Although we receive health insurance under the Medicare program, our prescription drug costs are very high, and we can only afford to visit the hospital once or twice a year when we are very sick. Because of the high cost of our prescriptions, we often have to choose between our medication and our groceries. (Story Source: Lao Assistance Center of Minnesota)

How does the Affordable Care Act (ACA) help elders who are Medicare and Medicaid Recipients? For too long, elders like Soukai and Soudchai have been forced to make impossible choices between lifesaving medication and basic essentials like food. The Affordable Care Act (ACA) will provide relief from expensive prescription medication and improve the wellness of elders like the Lukhamchaks. If you are a senior and on Medicare or Medicaid, here is how you can benefit from the ACA: 

Cheaper prescription drugs: If you are on Medicare Part D, you will receive help paying for your prescription drugs. Depending on how much you currently pay for prescription drugs, you may be able to save 50% on your brand name drug costs. Costs for generic drugs will also be cheaper. From now until 2020, Medicare will also gradually include more discounts on prescription drugs.

Free preventative care: Under Medicare, you can now go to the doctor for regular check-ups, screenings, and vaccinations for free. This includes diabetes screening, cervical cancer screenings, prostate cancer screenings, flu shots, and more. An annual wellness exam will also be free.

Lower costs: The cost of the Medicare Part B annual deductible for 2012 will be $22 dollars less than last year: from $162 in 2011 to $140 in 2012. The savings in Medicare Part B, along with the cost of living increase under Social Security, means that you will be able to take home approximately an extra $40 each month.

Benefits for new Medicare patients: If you are a new Medicare patient, you will receive a free “Welcome to Medicare” preventative visit with your doctor to create a personal care plan for you. This visit will include basic health tests such as blood pressure and vision screenings, and a review of your medical history, current health conditions, and prescription medications.

Ends limits on insurance coverage: Previously, many insurance policies limited how much money they would pay for your health care either annually or through the course of your lifetime. This meant that if you developed a chronic, costly health condition, you risked running out of insurance coverage


and having to pay out of pocket. Under the new law, lifetime limits have been eliminated. Annual limits will gradually be eliminated; in 2012 the annual limit has been raised to $2 million. 

More support for you to live at home: Before health care reform, Medicaid patients who needed longterm care such as assistance with daily activities like bathing, meal preparation, household chores or financial management would have to move into a nursing facility to receive services. Under the new law, Medicaid patients will have more options to help pay for long-term supports outside of nursing facilities so that they can receive care and services in their own home and community.

Protection from elder abuse and Medicare fraud: The new law strengthens the power of the government to protect you from Medicare fraud. Changes include more money put into anti-fraud programs, using technology to track crimes, and punishing fraud criminals who steal from Medicare with higher fines. The Elder Justice Act was also included in health care reform and will help fight abuse and neglect in nursing homes through better training for nursing staff.

Please contact Jonathan Tran at jonathan@searac.org for more information or if you have questions regarding the Affordable Care Act and other health care policy issues.

SEARAC – Washington, DC Office 1628 16th Street, NW Washington, DC 20009 Phone: (202) 667-4690 www.searac.org

SEARAC – California Office 1225 8th Street, Suite 590 Sacramento, CA 95814 Phone: (916) 428-7769 www.searac.org


Better Health Care for Elders: How Medicare and Medicaid Recipients Benefit from the ACA